Individual
STEFANY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 KAMOKILA BLVD, KAPOLEI, HI 96707-2014
(808) 591-6060
Mailing address
1001 KAMOKILA BLVD, KAPOLEI, HI 96707-2014
(808) 591-6060
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
627
HI
103K00000X
Behavior Analyst
7401001020
MI
Other
Enumeration date
02/27/2020
Last updated
05/09/2023
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